Evidence map›Paper›PMID 31730011›Full record

ReviewSystematic reviews2019

Comparative effectiveness and safety of pharmacological and non-pharmacological interventions for insomnia: an overview of reviews.

Patricia Rios, Roberta Cardoso, Deanna Morra, Vera Nincic, Zahra Goodarzi, Bechara Farah, Sharada Harricharan, Charles M Morin, Judith Leech, Sharon E Straus and 1 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Systematic reviews, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

55 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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  2. [Practice guideline for adult burn rehabilitation nursing (2026 edition)].Zhonghua shao shang yu chuang mian xiu fu za zhi · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Patricia RiosKnowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, Ontario, M5B 1W8, Canada.
Roberta CardosoKnowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, Ontario, M5B 1W8, Canada.
Deanna MorraKnowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, Ontario, M5B 1W8, Canada.
Vera NincicKnowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, Ontario, M5B 1W8, Canada.
Zahra GoodarziDivision of Geriatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Bechara FarahThe Canadian Agency for Drugs and Technologies in Health, 865 Carling Ave., Suite 600, Ottawa, Ontario, K1S 5S8, Canada.
Sharada HarricharanThe Canadian Agency for Drugs and Technologies in Health, 865 Carling Ave., Suite 600, Ottawa, Ontario, K1S 5S8, Canada.
Charles M MorinÉcole de Psychologie, 2325, rue des Bibliothèques, Québec, Québec, G1V 0A6, Canada.
Judith LeechDivision of Respirology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Sharon E StrausKnowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, Ontario, M5B 1W8, Canada.
Andrea C TriccoKnowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, Ontario, M5B 1W8, Canada. TriccoA@smh.ca.

Funding

CIHR
6 · The paper itself

Abstract

backgroundThis review aimed to assess the existing evidence regarding the clinical effectiveness and safety of pharmacological and non-pharmacological interventions in adults with insomnia and identify where research or policy development is needed.

methodsMEDLINE, Embase, PsycINFO, The Cochrane Library, and PubMed were searched from inception until June 14, 2017, along with relevant gray literature sites. Two reviewers independently screened titles/abstracts and full-text articles, and a single reviewer with an independent verifier completed charting, data abstraction, and quality appraisal.

resultsA total of 64 systematic reviews (35 with meta-analysis) were included after screening 5024 titles and abstracts and 525 full-text articles. Eight of the included reviews were rated as high quality using the Assessment of Multiple Systematic Reviews 2 (AMSTAR2) tool, and over half of the included articles (n = 40) were rated as low or critically low quality. Consistent evidence of effectiveness across multiple outcomes based on more than one high- or moderate quality review with meta-analysis was found for zolpidem, suvorexant, doxepin, melatonin, and cognitive behavioral therapy (CBT), and evidence of effectiveness across multiple outcomes based on one high-quality review with meta-analysis was found for temazepam, triazolam, zopiclone, trazodone, and behavioral interventions. These interventions were mostly evaluated in the short term (< 16 weeks), and there was very little harms data available for the pharmacological interventions making it difficult to evaluate their risk-benefit ratio.

conclusionsAssuming non-pharmacological interventions are preferable from a safety perspective CBT can be considered an effective first-line therapy for adults with insomnia followed by other behavioral interventions. Short courses of pharmacological interventions can be supplements to CBT or behavioral therapy; however, no evidence regarding the appropriate duration of pharmacological therapy is available from these reviews. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017072527.

Indexed as

Cognitive Behavioral TherapyAntidepressive AgentsAntipsychotic AgentsAzepinesBenzodiazepinesComparative Effectiveness ResearchHumansHypnotics and SedativesMelatoninSleep Aids, PharmaceuticalSleep Initiation and Maintenance DisordersSystematic Reviews as TopicTriazolesZolpidemAntidepressive AgentsAntipsychotic AgentsAzepinesBenzodiazepinesHypnotics and SedativesMelatoninSleep Aids, PharmaceuticalsuvorexantTriazolesZolpidemComparative effectivenessInsomniaKnowledge synthesisOverview of reviewsSleep disorders

Identifiers

PMID31730011
PMCPMC6857325

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.